What is a Pap smear?
A Pap smear is a procedure carried out by a healthcare professional to remove superficial cells, or a specific liquid, by lightly rubbing with a small brush, spatula or special cotton swab. The sample is then placed on a glass slide for microscopic examination to detect any abnormalities.
Different types of smear?
There are different types of smear:
- Cytological smears, to observe cell morphology
- Microbiological smears are used to detect the presence of markers, bacteria or viruses.
Gynecological smears are quite common, and there are several types:
- Cervico-uterine smear: involves taking a sample of cells from the cervix to observe their appearance and detect possible cancer or precancerous lesions.
- Vaginal swab: involves taking cells from the vagina to study the microbial flora and look for the presence of infections.
Blood, urine and anal smears are also available.
What are the benefits of smears?
Here, we'll focus on the cervico-uterine smear, which is essential to prevent advanced stages of cervical cancer caused by the human papilloma virus. Cervical cancer is a silent disease, sometimes causing no symptoms for many years as it slowly develops in the body. Yet it is the second most common cause of cancer in women worldwide. That's why it's so important to have a smear test.
At what age should you have your first smear test, and how often afterwards?
Firstly, a vaginal swab should be taken if symptoms such as abnormal vaginal discharge, itching, mycosis or discomfort occur.
Then, according to the Institut National du Cancer, cervical cancer screening is recommended from the age of 25 (although there is a risk from first intercourse), then the following year, and then every 3 years until the age of 65.
However, the presence of certain abnormal results or exposure to infections will necessitate more frequent smear tests.
How to prepare for a smear test
It's advisable to avoid sexual relations for 48 hours before a gynecological appointment. What's more, smear tests cannot be carried out during menstruation or when bleeding occurs, so it's best to book an appointment around mid-cycle. Nor can it be carried out if you are suffering from a local infection, or after using local ova or cream. You should therefore wait about 4 weeks after treatment of an infection before taking a smear. Nor should you perform intimate hygiene before a smear test.
All these recommendations are very important, as they enable the health professional to carry out a smear test under the best possible conditions. In fact, 30 to 60% of false-negatives are due to incorrect sampling, which leads to poor-quality results.
Who can perform the examination?
A smear test is a medical procedure that must be prescribed by a healthcare professional. It should be noted that the sample must be taken with your consent, and that you have the right to accept or refuse it.
Cervical smears and vaginal swabs can be taken by a gynecologist as part of a routine check-up, or in the event of specific symptoms. But they can also be carried out by your GP, a midwife or a biologist from a medical analysis laboratory.
How is the examination carried out?
Pap smears are a fairly quick examination: the practitioner places you in the gynaecological position, then inserts a speculum into your vagina to spread the vaginal walls so that he can insert a cotton swab, small spatula or small brush to collect cells. Then, as explained above, the samples are placed on a glass slide with a dye and sent to the laboratory for analysis.
Smears are usually preceded or followed by an interview.
Most smears are painless, although some pain may be felt, depending on the patient.
What's more, a small amount of bleeding may occur after a smear test, mainly as a result of "scraping". You can therefore wear menstrual panties to avoid any inconvenience after the examination.
The results are obtained after around 3 weeks, and are communicated to the patient. If an abnormality is detected, the doctor may prescribe further tests.
